Organization
RUSH UNIVERSITY MEDICAL CENTER
Active
Parent organization
RUSH UNIVERSITY MEDICAL CENTER
Other names
University Gynecological Oncology Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
RUSH UNIVERSITY MEDICAL CENTER
Authorized official
JACOB ROTMENSCH M.D. (DELEGATED OFFICIAL)
(312) 942-6300
Entity
Organization
Contact information
Practice address
1725 W HARRISON ST, SUITE 842, CHICAGO, IL 60612-3841
(312) 942-6307
(312) 942-6300
Mailing address
1725 W HARRISON ST, SUITE 842, CHICAGO, IL 60612-3841
(312) 942-6300
(312) 942-6301
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633443
BC PPO
IL
Enumeration date
03/30/2006
Last updated
03/30/2010
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